Introduction
Abdominoperineal resection removes the lower rectum and anus through abdominal and perineal incisions. It is used for selected cancers and rare inflammatory conditions when sphincter-preserving surgery is not possible.
A permanent colostomy (stool outlet on the abdominal wall) is usually created. APR may be part of a larger cancer plan including chemotherapy or radiation. Decisions should involve a multidisciplinary oncology team.
Why it is done / when it is considered
Abdominoperineal Resection (APR) is commonly discussed in situations such as:
- Low rectal or anal canal cancer when the anal sphincter cannot be saved
- Selected recurrent or locally advanced disease
- Rare non-cancer conditions when other options fail
- Persistent disease after prior treatment
How the procedure is done
- Performed under general anesthesia via abdominal and perineal approaches
- Lower rectum, anus, and surrounding tissue are removed
- Permanent colostomy is fashioned; perineal wound is closed
- Open or minimally assisted techniques depend on center and case
Preparation
- Staging scans, biopsy confirmation, and anesthesia clearance
- Stoma site marking and stoma care education before surgery when possible
- Nutrition support and smoking cessation improve healing
- Plan psychological support and help at home for recovery
Risks and possible complications
Risks differ by procedure. Your age, other illnesses, and anaesthesia plan change the picture—your care team will explain what applies to you.
- Bleeding, infection, and slow perineal wound healing
- Effects on urinary or sexual function due to nerve involvement
- Stoma complications such as retraction, hernia, or skin irritation
- Blood clots, anesthesia risks, and chronic pain
Recovery
- Hospital stay is often longer than for sphincter-sparing rectal surgery
- Gradual return to diet and mobility; physiotherapy may help
- Perineal wound healing may take weeks to months
Aftercare and follow-up
- Learn stoma appliance changes and skin protection
- Attend oncology follow-up for further treatment decisions
- Seek urgent care for fever, severe pain, or stoma blockage or heavy bleeding
Frequently asked questions
Will I have normal bowel movements through the anus after APR?
No. Stool exits through the colostomy; the anal route is not preserved.
Can people live normally with a colostomy?
Many return to work and social life with training and support.
Does every rectal cancer need APR?
No. Many tumors can be treated with sphincter-saving surgery or non-operative strategies.
Important caution
This article is general health information. It is not personal medical advice, a surgery recommendation, or a cost promise.
Decide on need, alternatives, risks, and cost with your doctor and hospital. If you have emergency symptoms, go to hospital without delay.